Individual
MS. STEPHANIE SPAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, LMHC, CADC 1
Contact information
Practice address
2929 SW MULTNOMAH BLVD, SUITE 304, PORTLAND, OR 97219-4025
(503) 452-0240
Mailing address
2929 SW MULTNOMAH BLVD, SUITE 304, PORTLAND, OR 97219-4025
(503) 452-0240
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
99-11-44
OR
101YM0800X
Mental Health Counselor
LH00010972
WA
101YP2500X
Professional Counselor
Primary
C1392
OR
Other
Enumeration date
05/02/2007
Last updated
06/21/2013
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